DR. SUE ANN RAVENSCRAFT (NPI# 1194700864) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194700864 |
| Entity Type | Individual |
| Full Name | DR. SUE ANN RAVENSCRAFT |
| Practice Address |
Park Nicollet Clinic Meadowbrook 6490 Excelsior Blvd # W300 St Louis Park MN 55426 |
| Mailing Address |
3931 Louisiana Ave S Ste 300w St Louis Park MN 55426-5000 |
| Practice Telephone | 9529933242 |
| Practice Fax Number | 9529932828 |
| Mailing Telephone | 9529933341 |
| Mailing Fax Number | 9529930300 |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2020-02-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
30297 | MN | Allopathic & Osteopathic Physicians |
| Street Address |
PARK NICOLLET CLINIC MEADOWBROOK 6490 EXCELSIOR BLVD # W300 |
| City | ST LOUIS PARK |
| State | MN |
| Zip Code | 55426 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821657545 | Big Brain Concussion Recovery & Chiropractic Pa | Chiropractor | 3313 Republic Ave., St. Louis Park, MN 55426 | 2019-06-06 |
| 1912485095 | Daniel Raies | Optometrist | 8900 Minnesota 7, St Louis Park, MN 55426 | 2018-08-01 |
| 1649756040 | Wayside House, Inc. | Clinic/Center | 1349 Jersey Ave S, St. Louis Park, MN 55426 | 2018-07-18 |
| 1104302884 | Superior Caregivers, LLC | In Home Supportive Care | 1319 Lancaster Ave., St. Louis Park, MN 55426 | 2018-07-16 |
| 1396234266 | Caitlin Kwiatkowski | Behavior Technician | 7010 Mn-7, St.louis Park, MN 55426 | 2018-05-07 |
| 1497244313 | Kelly Ann Clancey | Behavior Technician | 7010 Highway 2, Saint Louis Park, MN 55426 | 2018-05-07 |
| 1770072696 | Ashleigh Hakala | Behavior Technician | 7010 Highway 7 St. Louis Park Mn 55426, St. Louis Park, MN 55426 | 2018-05-07 |
| 1689181521 | Glenda Miles | Registered Nurse | 7316 Cedar Lake Road, Apt 8, St Louis Park, MN 55426 | 2017-12-31 |
| 1174041875 | Kristen Webb | Physician Assistant | 3931 Louisiana Ave S, Suite E-500, St. Louis Park, MN 55426 | 2017-09-01 |
| 1447775549 | Belinda Sue Bliss | Marriage & Family Therapist | 3301 Decatur Lane, Saint Louis Park, MN 55426 | 2017-08-09 |
| Find all providers in zip 55426 | ||||
| Taxonomy Code | 207RP1001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Pulmonary Disease |
| An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669459590 | Laurel A Wright | Internal Medicine | 6490 Excelsior Blvd, Ste W301, St Louis Park, MN 55426-4705 | 2005-12-30 |
| 1710964937 | Lisa M Bolin | Internal Medicine | 6490 Excelsior Blvd, Ste W300, St Louis Park, MN 55426-4705 | 2005-12-29 |
| 1346227444 | Asra Mohiuddin | Internal Medicine | 6490 Excelsior Blvd, Suite W300, St Louis Park, MN 55426-4705 | 2005-12-29 |
| 1912984048 | Nicolette Myers | Internal Medicine | 6490 Excelsior Blvd, Suite W300, St Louis Park, MN 55426-4705 | 2005-12-29 |
| 1003892860 | Keith Harmon | Internal Medicine | 6490 Excelsior Blvd, Suite W300, St Louis Park, MN 55426-4705 | 2005-12-22 |
| 1487639662 | Kevin H Komadina | Internal Medicine | 6490 Excelsior Blvd, Ste W300, St Louis Park, MN 55426-4705 | 2005-12-12 |
| 1760466676 | Salim A Kathawalla | Internal Medicine | 6490 Excelsior Blvd, Ste W300, St Louis Park, MN 55426-4705 | 2005-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548789910 | Sleepmedrx LLC | Internal Medicine | 7701 York Ave S Ste 100, Edina, MN 55435-5849 | 2017-09-16 |
| 1033354097 | Norman G Hepper | Internal Medicine | 1809 Hiawatha Ct Ne, Rochester, MN 55906-8014 | 2008-12-04 |
| 1841447083 | John Mcdougall | Internal Medicine | 1460 75th St Ne, Rochester, MN 55906-8903 | 2008-08-19 |
| 1396867909 | Abbie Lynn Begnaud | Internal Medicine | 516 Delaware Street, Clinic 6a, Umphysicians Medicine Specialties Clinic, Minneapolis, MN 55455 | 2007-04-04 |
| 1114068863 | Northwind Lung Specialists, P.a. | Internal Medicine | 3758 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2629 | 2007-02-08 |
| 1679593925 | Joan Mk Fox | Internal Medicine | 920 E 28th St # St5, Suite 700, Minneapolis, MN 55407-1139 | 2006-07-20 |
| 1871534214 | James W Leatherman | Internal Medicine | 701 Park Ave S, S1, Minneapolis, MN 55415-1623 | 2006-06-09 |
| 1649225012 | Conrad Iber | Internal Medicine | 606 24th Avenue South, Suite 106, Ump Sleep Medicine Clinic, Minneapolis, MN 55454-1437 | 2006-05-24 |
| 1831162395 | Jannica L Groom | Internal Medicine | 401 Phalen Boulevard, Mail Stop 41, St Paul, MN 55101-5302 | 2006-02-07 |
| 1326426818 | Synaptrx Sleep, LLC | Internal Medicine | 5565 Blaine Ave, Ste 225 / 275, Inver Grove Heights, MN 55076-1238 | 2015-05-15 |
| Find all providers with the same taxonomy | ||||
| City | ST LOUIS PARK |
| Zip Code | 55426 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.